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Cardiology

MIAMI VA HEALTHCARE SYSTEM

Jennifer Cudris Maldonado, MD George R. Marzouka, MD

Dr. Jennifer Cudris Maldonado joined the Miami VA Dr. George R. Marzouka was named the Chief of
Healthcare System in March of 2017 as the Echocardiography the Miami VA Healthcare System in early
Hematology/Oncology Division Chief after more than a 2017, while continuing as a Non-Invasive Cardiologist and
decade as an Emergency Department Physician in Affiliate Assistant Professor of Medicine University of
Colombia. She completed her initial studies at the Pontificia Miami – Miller School of Medicine.
Universidad Javeriana Bogotá, before her residency at For Dr. Marzouka, working at the Miami VA Healthcare
Jackson Memorial Hospital in Miami and the University of System allowed him to meet his professional goals while
Miami. She was later the chief medical resident at University also serving a unique and deserving population of patients.
of Massachusetts/Berkshire Medical Center in Pittsfield, MA and completed her “I choose to work at the VA because it is a supportive environment that allows me
Hematology/Oncology fellowship at Jackson Memorial Hospital in Miami and the to continue to grow professionally, teach, and pursue my research interests all while
University of Miami. giving back to the men and women who sacrificed so much to defend the freedoms I
enjoy.”
Jean-Philippe Austin, MD
Michael David Dyal, MD
Dr. Jean-Philippe Austin is the Chief of Radiation and
Oncology Service at the Miami VA Healthcare System and Miami VA Healthcare System Interventional Cardiologist
has served Veterans with VA since 2013. Through his serv- Dr. Michael David Dyal joined VA in 2016 while continuing
ice, thousands of Veterans receive the care they’ve earned his role as an Assistant Professor of Medicine at the
during what can often be one of the most difficult times in University of Miami. As a physician with the Miami VA
their lives. "I have worked in academia and the private sec- Healthcare System, he will have the opportunity to serve the
tor most of my career, but these past few years at the Miami more than 56,000 Veterans who choose VA for their health-
VA have been the most gratifying,” said Dr. Austin. “The care needs each year. In addition to his role in our cardiolo-
veterans are truly special in so many ways, and the most gy service, Dr. Dyal also serves Veterans in the Bruce W.
appreciative group of folks that I have ever had the pleasure to serve. It has been an Carter VA Medical Center Emergency Department.
amazing experience for me."
As for what separates working at the Miami VA Healthcare System from his other
experiences? "The medical records, all films, all lab results, are readily available in one
place. The other specialties are readily available, and best of all you are not fighting
insurance companies to ok or approve a test that may be costly, but is needed. It
should be a model for future healthcare in this country."

FAU Study Says Some Nursing

Homes Gaming the System to Palm Beach Gardens Doctor

Improve Their Medicare Star Ratings First in Florida to Use

Heartlight® Endoscopic
For families faced with the difficult decision of placing a loved one in a nursing home,
a government rating system is often the only source of information to determine which
facilities are the best. However, a new study of nursing homes in California, the nation’s Ablation System
largest system, by faculty at Florida Atlantic University and the University of
Connecticut, found that some nursing homes inflate their self-assessment reporting to for Treatment of AFib
improve their score in the Five-Star Quality Rating System employed by Medicare to help
consumers.
“We were able to empirically demonstrate that inflation does exist in the current sys- There is new hope for South Florida resi-
tem,” said Xu Han, assistant professor in the Department of Information Technology & dents who suffer from atrial fibrillation
Operations Management within FAU’s College of Business, who co-authored the study (AFib), the most common type of heart
with Niam Yaraghi and Ram Gopal from UConn’s School of Business. “So many nursing arrhythmia. Cardiac electrophysiologist, Dr.
homes have a five-star rating; they look like they’re luxury hotels, but it’s difficult to see David Weisman will offer a new, FDA-
through that and determine what kind of service they’re actually providing. In reality, approved, laser balloon treatment option
many of them are not really providing five-star services.” known as the HeartLight® Endoscopic
The five-star rating system that Medicare uses to compare nursing homes is made up Ablation System by Cardiofocus®. Dr.
of three components: employing a base score from an objective, on-site inspection, along Weisman is the first and only cardiac electro-
with two scores from information on staffing and quality reported by the facility. Patients, physiologist in the state of Florida using the
physicians and payers rely heavily on these overall ratings, which have climbed higher as HeartLight® Endoscopic Ablation System to
self-reported scores have trended upward. treat heart arrhythmias associated with AFib.
The study, recently published in the journal, Production and Operations Management, This minimally invasive treatment option is
investigates whether these rating improvements reflect actual quality gains or unjustified used for AFib patients whose heart arrhythmias cannot be controlled with
ratings inflation. Among the study’s findings: medication. The outpatient procedure typically takes less than three hours
- Nursing homes that have more to gain financially from higher ratings are more likely and in most cases patients can go home from the hospital the very next
to improve their overall rating through self-reporting. day.
- Little direct correlation exists between self-reported measures and on-site inspection Dr. Weisman maneuvers the HeartLight System electrophysiology
results, either contemporaneously or over time. equipment into the heart via a minimally invasive groin incision, to deliver
- The number of resident complaints is similar for nursing homes with the same precise and controlled laser energy to diseased areas of the heart. He said
inspection rating but varies noticeably between facilities with the same overall rating, that the HeartLight System is the latest technology on the market for the
which suggests inflation in self-reported measures. treatment of AFib. The unique benefit of this ablation system, versus other
- At least 6 percent of the nursing homes inflate their self-reported measures, which options on the market, is the availability of the visually guided laser bal-
include quality measures on patient health, as well as staffing numbers. loon technology to control laser treatment consistently during pulmonary
The study provides systematic evidence that some nursing homes are inflating the self- vein isolation (PVI) for AFib treatment.
reported measures in Medicare’s star rating system. By showing that there is a manageable
number of facilities that are likely inflators and identifying key predictors of being an
inflator, the researchers said the findings can help Medicare focus its future audits more
strategically and improve its inspection process and ratings system.
please

32 February 2018 southfloridahospitalnews.com South Florida Hospital News